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ORTHOPAEDICS, TRAUMATOLOGY and PROSTHETICS
Article . 2020 . Peer-reviewed
Data sources: Crossref
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Subacute compartment syndrome in case of gunshot injuries of the extremities

Authors: Strafun, Sergiy; Laksha, Andriy; Shipunov, Volodymyr; Borzykh, Natalia; Strafun, Oleksandr;

Subacute compartment syndrome in case of gunshot injuries of the extremities

Abstract

A local hypertensive ischemic syndrome or compartment syndrome (CS) is a serious complication of gunshot injuries of the extremities (GIE), it is usually considered as an acute process. However, we have repeatedly observed patients with subacute course of this pathology. Objective: to study cases of subacute CS (SaCS) with GIE, that are characterized by a latent course and veiled clinical picture of the complications. Methods: there were 15 cases of subacute CS after gunshot injuries for the period 2014–2018. 9 (60 %) were combined injuries of trunk and limbs, 6 (40%) — isolated limb wounds. Lesions of the lower extremities predominated — 10 (66.6 %). In 8 (53.3 %) patients, SaCS developed after shrapnel wounds of the limbs, and in 5 (33.3 %) cases — mine-explosive. Results: in 9 (60 %) cases, SaCS was observed in the bone-fascial sheath of the damaged area of the limb, in 6 (40 %) — in the adjacent segment. In 10 (66.6 %) patients, the course of SaCS was preceded by major vessels injury, in 8 (53.3 %) cases — it was combined with peripheral nerves injuries. In 12 wounded at the stages of evacuation, a tourniquet was used for more than an hour. In 5 cases, the course of SaCS was observed in patients with a combined wound of two or more anatomical sites with the development of a shock or prolonged hypotension. The time from the moment of injury to secondary surgical treatment, when the morphological signs of existed local hypertensive ischemic syndrome in bone-fascial sheath were identified, was from 5 days to 3 weeks. Conclusions: CS in case of GIE can have both acute and subacute flow patterns. SaCS usually develops in the intact segment of the injured limb without pronounced clinical manifestations. Risk factors for the course of SaCS: injuries of the main vessels, tourniquet for more than an hour, multilevel injuries with the development of a shock or prolonged hypotension, incomplete (untimely) fasciotomy at the evacuation stages.

Keywords

огнестрельные повреждения конечностей, підгострий компартмент-синдром, місцевий гіпертензивний ішемічний синдром, gunshot injuries of the extremities, местный гипертензивный ишемический синдром, вогнепальні ушкодження кінцівок, подострый компартмент-синдром, local hypertensive ischemic syndrome, subacute compartment syndrome

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
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